Effectiveness and safety of early enteral nutrition for patients who received targeted temperature management after out-of-hospital cardiac arrest

Ide, Kazuki; Ide, Kazuki; Kawasaki, Yohei; Takeda, Chikashi; Seki, Tomotsugu; Usui, Tomoko; Kawakami, Koji

doi:10.1016/j.resuscitation.2019.01.007

Cited by 18 publications

(22 citation statements)

References 26 publications

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“…Joo et al report a much lower incidence of intestinal ischemia (0.4% based on hospital coding). 32 Our rate of intestinal ischemia was much higher (5.5%) perhaps due to the refractory arrest population with longer ischemic times and need for mechanical hemodynamic support and higher vasoactive medication requirements. Use of hospital coding data in the Joo et al study may also underreport cases of intestinal ischemia while our study may demonstrate a higher rate of complications due to the detailed chart review and uniform use of computed tomography scanning in all patients.…”

Section: Discussionmentioning

confidence: 77%

“…The largest benefit of early enteral nutrition is expected in patients who are malnourished at presentation. 32,33 In contrast, the patients in this study were ambulatory and living independently prior to admission, which may limit the benefits of early feeding. Finally, critically ill patients have delayed gastric emptying while TTM may further potentiate gut dysmotility.…”

Section: Discussionmentioning

confidence: 90%

“…They compared patients with early enteral feeding (initiated within 48 h of admission) to all others and found no difference in 30 day mortality. 32 In another retrospective study of adults admitted for TTM after cardiac arrest, early initiation of nutrition (initiated within 48 h of admission) was associated with improved mortality (OR 0.35; CI 0.2À0.5) and better 3-month neurologic outcomes as assessed by CPC 1À2 (OR 3.47; CI 1.48À8.14) compared to late enteral feeding. 20 Importantly, in both of these studies, patients who did not receive enteral feeding were included in the delayed feeding group.…”

Section: Discussionmentioning

confidence: 97%

“…17,19,40 However, given concerns for bowel ischemia and increased risk of pneumonia, feeding initiation is frequently delayed in critically ill patients. 18,20,32 Multiple studies have examined the effects of early nutrition in cardiac arrest populations. In a retrospective analysis Joo et al looked at more than 400 propensity score matched patients with out-ofhospital cardiac arrest receiving TTM including 13% who were also supported with ECMO.…”

Section: Discussionmentioning

confidence: 99%

“…Combining the group who is never fed with the delayed nutrition cohort is likely to decrease the latter group's apparent survival. 20,32 When we included patients who were not fed at any time in the delayed feeding group, the significant difference in mortality (55.9% versus 69.4%, OR 0.56; 95% CI 0.25, 1.23; p = 0.15) and neurologically favorable survival (55.9% vs 49.1%; OR 0.92; 95% CI 0.39,2.16; p = 0.85) was negated.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes associated with delayed enteral feeding after cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation and targeted temperature management

et al. 2021

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Introduction: While early enteral nutrition is generally preferred in critically ill patients, the optimal timing of feeding among refractory cardiac arrest patients is unknown. We examined the association between timing of enteral nutrition and patient survival and safety outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA) who were treated with extracorporeal cardiopulmonary resuscitation (ECPR).Methods: We performed a retrospective analysis of 142 consecutive patients presenting with OHCA due to ventricular fibrillation or ventricular tachycardia treated with ECPR and targeted temperature management (TTM). Neurologically favorable survival and clinical outcomes were compared between patients who received early enteral nutrition (<48 h after admission to the intensive care unit) and patients receiving delayed enteral nutrition (initiated >48 h after admission).Results: Enteral nutrition was initiated in 90/142 (63%) patients. Early enteral nutrition was provided in 34/90 (38%) while delayed nutrition occurred in 56/90 (62%). In adjusted analysis including patients who received nutrition, delayed enteral feeding was associated with increased odds of neurologically favorable survival (29 vs 54%, CI 1.04À7.25, p = 0.04). There were no significant differences in the incidence of pneumonia (18 vs 27%, p = 0.16), gastrointestinal bleeding (5.9 vs 3.6%, p = 0.42), intestinal ischemia (5.9 vs 5.4%, p = 0.90), ileus (12 vs 11%, p = 0.98), or need for tracheostomy (15 vs 20%, p = 0.81) between early and late feeding groups. Conclusion:In patients with refractory OHCA treated with ECPR and TTM, delayed enteral nutrition was associated with improved neurologically favorable survival. Adverse events related to enteral feeding were not associated with timing of feeding initiation.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcomes associated with delayed enteral feeding after cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation and targeted temperature management

et al. 2021

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Effectiveness and safety of early postpyloric feeding during therapeutic hypothermia in patients with large hemispheric infarction: A retrospective cohort study

Cao

Chang

et al. 2023

Nut in Clin Prac

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BackgroundWhat kind of feeding should be provided during therapeutic hypothermia (TH) in patients with large hemispheric infarction (LHI) is not clear. Therefore, we conducted a retrospective observational study to determine whether providing early postpyloric feeding (PPF) (<24 h after admission) is beneficial or harmful for patients with this condition.MethodsThis study retrospectively screened 78 patients with LHI who were treated with TH from one neurological intensive care unit (ICU). The patients were receiving either early PPF (n = 52) or early parenteral nutrition (PN) (n = 26). Data regarding 30‐day mortality, neurological outcome, nutrition‐related laboratory indicators, ICU hospitalization time, mechanical ventilation (MV) duration, and complications were collected.ResultsA greater number of patients who received early PPF had favorable neurologic outcome than those who received early PN (57.7% vs 30.7%, P = 0.025). The early PPF group had a lower severity of pulmonary infection than the early PN group, as measured by the Clinical Pulmonary Infection Score (7.33 ± 0.96 vs 9.42 ± 2.11, P = 0.006). The total protein and hemoglobin levels in the early PPF group were higher than those in the early PN group (59.56 ± 5.09 vs 56.52 ± 7.94 g/L, P = 0.046; 131.06 ± 19.58 vs 122.07 ± 17.72 g/L, P = 0.045). The MV duration and ICU hospitalization time were shorter in the early PPF group (13 [9;21] vs 21 [14;30] days, P = 0.006; 28 [22;36] vs 34 [33;51] days, P = 0.014). There were no significant differences in the incidence of catheter‐related bloodstream infections, 30‐day mortality, or nutrition intolerance between the two groups.ConclusionEarly PPF is an effective and safe enteral nutrition method for patients with LHI receiving TH.

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Effectiveness of intraoperative nicorandil in patients with a history of ischemic heart disease undergoing high-risk noncardiac surgery: a retrospective cohort study

et al. 2023

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Effectiveness and safety of early enteral nutrition for patients who received targeted temperature management after out-of-hospital cardiac arrest

Cited by 18 publications

References 26 publications

Outcomes associated with delayed enteral feeding after cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation and targeted temperature management

Outcomes associated with delayed enteral feeding after cardiac arrest treated with veno-arterial extracorporeal membrane oxygenation and targeted temperature management

Effectiveness and safety of early postpyloric feeding during therapeutic hypothermia in patients with large hemispheric infarction: A retrospective cohort study

Effectiveness of intraoperative nicorandil in patients with a history of ischemic heart disease undergoing high-risk noncardiac surgery: a retrospective cohort study

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